Role of Methacholine PC20 in FEF(25-75%) for the Diagnosis of Bronchial Asthma.

Son, Kyeong Min; Jang, Seung Hun; Kang, Hye Ryun; Han, Boram; Kim, Joo Hee; Kim, Hyun Sung; Park, Sung Hoon; Hwang, Yong Il; Kim, Dong Gyu; Jung, Ki Suck

doi:2009.67.4.311

Tuberc Respir Dis > Volume 67(4); 2009 > Article

Original Article

Tuberculosis and Respiratory Diseases 2009;67(4):311-317.
DOI: https://doi.org/10.4046/trd.2009.67.4.311 Published online October 1, 2009.

Role of Methacholine PC20 in FEF(25-75%) for the Diagnosis of Bronchial Asthma.

Kyeong Min Son, Seung Hun Jang, Hye Ryun Kang, Boram Han, Joo Hee Kim, Hyun Sung Kim, Sung Hoon Park, Yong Il Hwang, Dong Gyu Kim, Ki Suck Jung

Division of Pulmonary, Allergy, and Critical Care Medicine, Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea. chestor@hallym.or.kr

Abstract

BACKGROUND
The methacholine bronchial provocation test is a useful tool for evaluating asthma in patients with normal or near normal baseline lung function. However, the sensitivity of this test is 82~92% at most. The purpose of this study is to evaluate the clinical usefulness of FEF(25-75%) in identification of airway hyperresponsiveness in patients with suspected asthmatic symptoms. METHODS: One hundred twenty-five patients who experienced cough and wheezing within one week prior to their visiting the clinic were enrolled. RESULTS: Sixty-four subjects showed no significant reduction of FEV1 or FEF(25-75%) on the methacholine bronchial provocation test (Group I). In 24 patients, FEF(25-75%) fell more than 20% from baseline without a 20% fall of FEV1 during methacholine challenge (Group II). All patients who had more than 20% fall of FEV1 (n=37) also showed more than 20% of reduction in FEF(25-75%) (Group III). Baseline FEV1/FVC (%) and FEF(25-75%) (L) were higher in group II than group III (81.51+/-1.56% vs. 75.02+/-1.60%, p<0.001, 3.25+/-0.21 L vs. 2.45+/-0.21 L, p=0.013, respectively). Group II had greater reductions of both FEV1 and FEF(25-75%) than group I at 25 mg/mL of methacholine (p<0.001). The provocative concentration of methacholine causing a 20% fall in FEF(25-75%) in group II was about three-fold higher than that in group III. CONCLUSION: A 20% fall of FEF(25-75%) by methacholine provocation can be more sensitive indicator for detecting a milder form of airway hyperresponsiveness than FEV1 criteria.

Key Words: Methacholine, Bronchial provocation, FEF(25-75%)

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